Immunohistochemical Analysis of Lymphocyte Populations in Acute Skin Rejection: The University Health Network Addition to the Banff Classification

Siba Haykal, MD, PhD, FRCSC, FACS; Natasha Barone, MSc; Sara Rostami, DVM; Sajad Moshkelgosha, PhD; Stephen Juvet, MD, PhD, FRCPC; Shaf Keshavjee, MD, MSc, FRCSC, FACS; Danny Ghazarian, MD, PhD, FRCPC, FCAP

doi:10.1097/GOX.0000000000004831

Plastic and Reconstructive Surgery, Global Open (Mar 2023)

Immunohistochemical Analysis of Lymphocyte Populations in Acute Skin Rejection: The University Health Network Addition to the Banff Classification

Siba Haykal, MD, PhD, FRCSC, FACS,
Natasha Barone, MSc,
Sara Rostami, DVM,
Sajad Moshkelgosha, PhD,
Stephen Juvet, MD, PhD, FRCPC,
Shaf Keshavjee, MD, MSc, FRCSC, FACS,
Danny Ghazarian, MD, PhD, FRCPC, FCAP

Affiliations

Siba Haykal, MD, PhD, FRCSC, FACS: From the * Latner Thoracic Surgery Research Laboratories, Toronto General Hospital Research Institute, Department of Surgery, University Health Network, University of Toronto, Toronto, ON, Canada
Natasha Barone, MSc: ‡ Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
Sara Rostami, DVM: From the * Latner Thoracic Surgery Research Laboratories, Toronto General Hospital Research Institute, Department of Surgery, University Health Network, University of Toronto, Toronto, ON, Canada
Sajad Moshkelgosha, PhD: From the * Latner Thoracic Surgery Research Laboratories, Toronto General Hospital Research Institute, Department of Surgery, University Health Network, University of Toronto, Toronto, ON, Canada
Stephen Juvet, MD, PhD, FRCPC: From the * Latner Thoracic Surgery Research Laboratories, Toronto General Hospital Research Institute, Department of Surgery, University Health Network, University of Toronto, Toronto, ON, Canada
Shaf Keshavjee, MD, MSc, FRCSC, FACS: From the * Latner Thoracic Surgery Research Laboratories, Toronto General Hospital Research Institute, Department of Surgery, University Health Network, University of Toronto, Toronto, ON, Canada
Danny Ghazarian, MD, PhD, FRCPC, FCAP: § Department of Pathology, University Health Network, University of Toronto, Toronto, ON, Canada.

DOI: https://doi.org/10.1097/GOX.0000000000004831
Journal volume & issue: Vol. 11, no. 3
p. e4831

Abstract

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Background:. Acute rejection in vascularized composite allotransplantation has been identified using the Banff 2007 working classification. We propose an addition to this classification based on histological and immunological assessment within the skin and subcutaneous tissue. Methods:. Biopsies from vascularized composite transplant patients were obtained at scheduled visits and whenever skin changes occurred. Histology and immunohistochemistry were performed on all samples, looking at infiltrating cells. Results:. Observations were made specifically related to each component of the skin, including the epidermis, dermis, vessels, and subcutaneous tissue. Our findings led to the establishment of the University Health Network addition of skin rejection. Conclusions:. The high rate of rejection where the skin is involved requires novel techniques for early detection. The University Health Network skin rejection addition can serve as an adjunct to the Banff classification.

Published in Plastic and Reconstructive Surgery, Global Open

ISSN: 2169-7574 (Online)
Publisher: Wolters Kluwer
Country of publisher: United States
LCC subjects: Medicine: Surgery
Website: http://www.prsgo.com

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